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Real-time augmented reality navigation in brain glioma resection: a pilot feasibility study
Peihai Zhang1, Kai Zhang1, Huiting Liu2
1Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China.
Frontiers in Surgery
|June 15, 2026
Summary
Augmented reality (AR) navigation shows technical feasibility for brain glioma resection in a pilot study. While gross total resection was achieved, further research is needed to confirm clinical efficacy due to the small sample size.
Area of Science:
- Neurosurgery
- Medical Technology
- Image-Guided Therapy
Background:
- Brain gliomas pose significant surgical challenges.
- Accurate navigation is crucial for maximizing tumor resection while preserving neurological function.
- Emerging technologies like augmented reality (AR) offer potential advancements in surgical guidance.
Purpose of the Study:
- To assess the clinical feasibility and technical performance of AR navigation for brain glioma resection.
- To evaluate the accuracy and efficiency of AR-guided surgical planning and intraoperative navigation.
- To determine the impact of AR navigation on surgical outcomes and patient neurological function.
Main Methods:
- A pilot study involving 6 patients with brain gliomas.
- Integration of preoperative MRI, DTI, and MRA data into an AR head-mounted device for 3D model reconstruction.
- Intraoperative AR navigation guided by preoperative surgical planning and simulation.
- Evaluation of AR registration time, target registration error (TRE) against an optical navigation system, extent of resection, and neurological function (Modified Rankin Scale).
Main Results:
- Gross total resection of contrast-enhancing tumors was achieved in all 6 patients.
- Mean AR registration time was 4.7 ± 0.7 minutes.
- Surface-matching registration achieved a TRE of 2.1 ± 0.4 mm compared to the StealthStation reference.
- Significant improvement in postoperative Modified Rankin Scale scores at 3 months (p=0.03).
Conclusions:
- Augmented reality navigation is technically feasible for brain glioma resection.
- The system demonstrated acceptable accuracy and efficiency in this preliminary series.
- Larger studies are required to establish the definitive clinical efficacy of AR navigation in neurosurgery.
